ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
Pre-Discharge and Post-Discharge Management and Treatment Optimization in Acute Heart Failure [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2022; 50(5): 378-394 | DOI: 10.5543/tkda.2022.22329

Pre-Discharge and Post-Discharge Management and Treatment Optimization in Acute Heart Failure

Yüksel Çavuşoğlu1, Hakan Altay2, Sanem Nalbantgil3, Ahmet Temizhan4, Mehmet Birhan Yılmaz5
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Acute heart failure is associated with high mortality and rehospitalization rates and required urgent evaluation and early initiation or intensification of therapy. The risk of death and heart failure rehospitalization is greatest in the early post-discharge period, particularly within the first 3-6 months, and declines over time, which is referred as a vulnerable period of acute heart failure hospitalization. Therefore, implementation of guidelines-directed optimal therapy is not only so crucial in the acute phase but also very important in the pre-discharge and early post-discharge period in reducing mortality and rehospitalization rates. The pre-discharge period represents a window of opportunity for treatment optimization which includes to eliminate congestion, to treat comorbidities or precipitating factors, and to initiate or uptitrate oral therapy before discharge. Early assessment in the post-discharge period based on clinical evaluation and laboratory exams, further optimization of disease-modifying therapy is associated with lower 30-day hospitalization for heart failure. In clinical practice, clinicians usually focus on acute phase intravenous medications and short-term device therapies and, in fact, neglect short- and long-term comprehensive approaches. This paper reviews management strategies that may help reduce mortality and heart failure rehospitalizations in pre-discharge and post-discharge periods and include adopting holistic approaches for heart failure, increasing optimization of evidence-based therapies, treating cardiac and noncardiac comorbidities, improving care transitions, monitoring, and disease management.

Keywords: Acute heart failure, pre-discharge and post-discharge, management, treatment

How to cite this article
Yüksel Çavuşoğlu, Hakan Altay, Sanem Nalbantgil, Ahmet Temizhan, Mehmet Birhan Yılmaz. Pre-Discharge and Post-Discharge Management and Treatment Optimization in Acute Heart Failure. Turk Kardiyol Dern Ars. 2022; 50(5): 378-394

Corresponding Author: Yüksel Çavuşoğlu
Manuscript Language: Turkish


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